Care Health Insurance
Care Heart
Sum insured options: 5L, 10L, 20L, 50L
Feature DNA
Coverage Basics
Room Rent Limit
No sub-limit on any variant
Co-Payment
Nil (up to age 60); 10% mandatory above 61
Mandatory 10% co-pay for ages 61+ cannot be waived regardless of sum insured. This can significantly increase out-of-pocket costs for senior members.
Network Hospitals
9,800+
Daycare Procedures
540+ listed procedures
Waiting Periods
Pre-Existing Waiting
36 months
Specific diseases like knee replacement, cataract, and hernia carry a separate 24-month waiting period in addition to PED waiting.
Maternity Cover
Not covered in base plan
Maternity is not available even as an add-on on Care Heart. Those planning a family should look elsewhere.
Wellness Benefits
Mental Health
Covered per Mental Healthcare Act
AYUSH Coverage
Covered up to SI
Annual Health Checkup
Included after every claim-free year
Domiciliary Treatment
Covered up to SI
Claims Features
No Claim Bonus
Up to 50% cumulative bonus
NCB capped at 50% is lower than many competitors offering 100% or more.
Restoration Benefit
100% automatic restoration for any illness
Ambulance Cover
Up to 3,000 per hospitalisation
Organ Donor
Covered up to SI
Score Breakdown
Premium Estimates
Indicative annual premiums for a 5 lakh sum insured individual policy. Actual premiums vary by age, location, and health status.
| Age Group | Estimated Premium (5L SI) |
|---|---|
| Age 30 | ₹5,400/yr |
| Age 45 | ₹11,800/yr |
| Age 60 | ₹25,400/yr |
Key Exclusions
Gotcha Alerts (4)
Co-Payment
Mandatory 10% co-pay for ages 61+ cannot be waived regardless of sum insured. This can significantly increase out-of-pocket costs for senior members.
Source: Care Heart Policy Wording
Pre-Existing Waiting
Specific diseases like knee replacement, cataract, and hernia carry a separate 24-month waiting period in addition to PED waiting.
Source: Care Heart Policy Wording
No Claim Bonus
NCB capped at 50% is lower than many competitors offering 100% or more.
Source: Care Heart Policy Wording
Maternity Cover
Maternity is not available even as an add-on on Care Heart. Those planning a family should look elsewhere.
Source: Care Heart Policy Wording
Compare With Another Plan
Oquilia Analysis: Care Heart
Care Heart from Care Health Insurance is a individual health insurance plan that has earned an Oquilia Score of 7.6/10, placing it in the “Good” category. This score is derived from our analysis of 14 critical coverage parameters, cross-referenced against industry benchmarks and the actual policy wording filed with the Insurance Regulatory and Development Authority of India (IRDAI).
Starting with the coverage fundamentals, this plan offers no room rent sub-limits, which is a significant advantage. Room rent is one of the most consequential features in a health insurance policy because exceeding the limit does not just result in paying the room rent difference — it triggers proportionate deductions across the entire hospital bill, including surgery charges, doctor fees, and medication costs. For co-payment, this plan offers nil (up to age 60); 10% mandatory above 61, which means the policyholder will need to bear a portion of every claim from their own funds.
The pre-existing disease waiting period stands at 36 months, which is in line with industry standards. Buyers with existing health conditions should factor this waiting period into their purchase decision, as any claim related to a pre-existing condition during this period will be outright rejected.
On the wellness and benefits front, the plan includes coverage for AYUSH treatments (Covered up to SI), mental health (Covered per Mental Healthcare Act), and domiciliary treatment (Covered up to SI). The no-claim bonus structure offers Up to 50% cumulative bonus, which is reasonable but not the most competitive. Restoration benefit is a strong suit of this plan, providing 100% automatic restoration for any illness.
We flagged 4 gotcha alerts for this plan. These are fine-print conditions that most buyers overlook during purchase but discover painfully at claim time. Each gotcha is sourced directly from the policy wording and represents a material condition that could affect claim outcomes. We recommend reading each gotcha carefully and factoring them into your purchase decision.
In terms of value for money, the estimated premium for a 30-year-old at 5 lakh sum insured is ₹5,400 per year. When evaluated against the feature depth delivered at this price point, Care Heart offers reasonable value for its price segment, though buyers should weigh the gotcha alerts carefully. We recommend comparing this plan side-by-side with at least one alternative using the Oquilia comparison tool to ensure it aligns with your specific health profile and financial needs.
Frequently Asked Questions
What is the Oquilia Score for Care Heart?+
What are the key gotcha alerts for Care Heart?+
What is the estimated premium for Care Heart?+
Who should buy Care Heart?+
Does Care Heart cover pre-existing diseases?+
Not sure if Care Heart is right for you?
Compare it side-by-side with another plan to see which one wins feature-by-feature.